May 29th, 2011 
(Photo credit: Examiner.com)
Dear Miss A,
I have a friend who has melasma on her face. She’s getting very self-conscious about it, and it has been getting worse over the last 2 months following some sun exposure in March, and new spots have been appearing on her face. She’s tried an at-home chemical peel with 20% glycolic solution with no success. She did not suffer from melasma until she took Yaz, which she stopped taking last November. If possible, will please you point me in the direction of any products or services that you think might help? If my memory serves me correctly, you once struggled with melasma, so I thought I would ask.
Sincerely,
Concerned Friend
Dear Concerned Friend,
Thank you so much for writing me. Yes, I struggled with melasma back in 2006. Much like your friend, my melasma was from birth control pills. Estrogen and progesterone seem to play a role in melasma. It is common in pregnant women, women who are taking birth control pills, and also women taking hormone replacement therapy. I’m not sure if your friend switched from Yaz to another birth control pill, but if it’s possible to get off the pill completely and use another method of birth control, I would recommend that. She should talk with her gynecologist about options available to her.
Having melasma was actually great for me, in that it really forced me to take terrific care of my skin. I truly believe my skin looks better now than it did five years ago. Your friend will want to get rid of the top layer of skin to get rid of the damage, and reveal fresher skin with less hyperpigmentation. I suggest that she see a good Cosmetic Dermatologist for IPL (intense pulsed light), and/or chemical peels. She should consult with the physician about topical products that she can use nightly to help decrease the pigmentation. Products with Hydroquinone or Kojic Acid work well, but it will depend on her individual skin and any sensitivities.
I never did IPL, but plan to get a few IPL treatments soon. I have done some microdermabrasion, which didn’t do much for me. I did a few facials with light peels, but nothing major. What worked for me was my own routine. I like to exfoliate several times a week with a scrub like Lancer’s Polish, or Clinique’s Exfoliating Scrub. I also use a glycolic acid nightly. I started with M.D. Forte Lotion I, and worked my way up to II, and now I’m on III, which is 30% glycolic acid. These aren’t the consistency of a lotion. They are much more like a serum. M.D. Forte is made by Allergan, the makers of BOTOX® Cosmetic, JUVÉDERM® XC, and LATISSE®. They are transitioning the product line to Vivite, a new skincare line which features glycolic acid in each product. I really like the Vivite Night Renewal Facial Cream, which contains 20% glycolic.
Your friend will need to prevent additional darkening by staying out of the sun, or using tanning beds. Self-tanners and spray tans will darken the melasma, so I would suggest that she stop those as well, and get used to a more natural look. Like I say, Black is beautiful, but white is wonderful, too. No need to feel ashamed of being pale. She should use a good antioxidant daily. I suggest using Skinceuticals C E Ferulic which contains antioxidants to fight any damage, and it will also build collagen. The color of the serum should be a very, very pale yellow. Once it has turned orange, it works but not as effectively, so keep the product away from light and heat, and don’t leave the top off. She should get in the habit of wearing a good SPF daily. It’s not enough that moisturizer or foundation or powder has some sun protection. She needs to wear something she would wear by the pool or at the beach. And she shouldn’t wear this just in the summer, or just on sunny days. It should be worn under her makeup daily — in the winter, on rainy days, always.
Here is a list of some of the best sunscreens currently on the market:
MelaShade™
Titanium dioxide 10.2%, zinc oxide 3.7%.
SkinCeuticals Sheer Physical UV Defense SPF 50
A groundbreaking first-to-market mattifying fluid with transparent finish, this paraben-free, all-physical filter sunscreen provides increased protection in an ultra-sheer texture for all skin types, even very sensitive. Sheer Physical UV Defense SPF 50® offers the photoprotection of trusted broad-spectrum, physical filters, zinc oxide (Z-COTE®) and titanium dioxide, and is enhanced by artemia salina, a plankton extract, to increase the skin’s defenses and resistance to UV and heat stress. The unique ‘shake then apply’ action assures even distribution of active ingredients in this silky sheer fluid that dries quickly and leaves no residue.Broad Spectrum (Paraben & Chemical Free)
Elta MD UV Physical SPF 41
Tinted, oil-free, water-resistent (UVA/UVB Broad spectrum)sunscreen which blends nicely. Contains transparent Titanium and Zinc oxide and Chemical-free without Paraben.
Invisible Zinc Tinted SPF 30
Contains Zinc Oxide, but blends beautifully. It is chemical-free without Paraben.
JOURNÉE Bio-Restorative Day Cream with PSP
PSP is a naturally balanced mixture of essential skin nutrients that nourishes and revitalizes the skin’s outer layer. SPF 30 (UVA/UVB Broad spectrum), non-comedogenic, and fragrance free.
I hope that this is helpful! Please email me and let me know how it goes!
- Miss A
Really very useful information you have on your post.